RESUMO
Majority of anaerobes involved in dental infections are thought to be endogenous in origin. Due to breech of continuity of pulp chamber bacterial colonization occurs. Responsible pathogens are polymicrobial. If left untreated in early stages, it can act as foci of disseminated infections and spread rapidly to adjacent structures leading to life threatening conditions. Aims: The present study was undertaken to identify different anaerobic organisms and their association with risk factors. Methods: 40 pus samples were collected after mouth wash from patients presented with dental abscess. Samples were processed immediately for aerobic and anaerobic culture. After comparing with the aerobic culture, obligate anaerobes were checked for aero tolerance. Subculture done for identification of species by Gram stain, colony morphology and conventional biochemical tests. Final identification was done by Vitek 2 system. Results: 40 (100%) samples were culture positive. Total 60 bacterial isolates recovered from this 40 samples. Out of which aerobes 36 (60%) and anaerobes 24 (40%) isolated. Aerobes present in 18 (45%), anaerobes present in 12 (30%) cases and mixed aerobic and anaerobic flora in 10 (25 %) cases. Predominant isolates were anaerobic cocci, Peptostreptococcus micros (41.6%) followed by Peptostreptococcus anaerobios (25%).Diabetes mellitus, bad chewing habits, poor oral hygiene found as significant risk factors. Conclusion: This study highlights polymicrobial nature of infections and role of anaerobes play as pathogens. Early diagnosis and interventions are extremely important to prevent systemic complications. One should have a high index of suspicion of anaerobes while dealing with dental infections.
RESUMO
BACKGROUND: Human Immunodeficiency Virus Type 1 (HIV-1) viral load testing at regular intervals is an integral component of disease management in Acquired Immunodeficiency Syndrome (AIDS) patients. The need in countries like India is therefore an assay that is not only economical but efficient and highly specific for HIV-1 sub type C virus. This study reports a SYBR Green-based HIV-1 real time PCR assay for viral load testing and is designed for enhanced specificity towards HIV-1 sub type C viruses prevalent in India. RESULTS: Linear regression of the observed and reference concentration of standards used in this study generated a correlation coefficient of 0.998 (p<0.001). Lower limit of detection of the test protocol was 50 copies/ml of plasma. The assay demonstrated 100% specificity when tested with negative control sera. The Spearman coefficient of the reported assay with an US-FDA approved, Taqman probe-based commercial kit was found to be 0.997. No significant difference in viral load was detected when the SYBR Green based assay was used to test infected plasma stored at -20°C and room temperature for 7 days respectively (Wilcoxon signed rank test, p=0.105). In a comparative study on 90 pretested HIV-1 positive samples with viral loads ranging from 5,000 - 25,000 HIV-1 RNA copies/ml and between two commercial assays it was found that the later failed to amplify in 13.33% and 10% samples respectively while in 7.77% and 4.44% samples the copy number values were reduced by >0.5 log value, a figure that is considered clinically significant by physicians. CONCLUSION: The HIV-1 viral load assay reported in this study was found to be robust, reliable, economical and effective in resource limited settings such as those existing in India. PCR probes specially designed from HIV-1 Subtype C-specific nucleotide sequences originating from India imparted specificity towards such isolates and demonstrated superior results when compared to two similar commercial assays widely used in India.